Everything someone needs to know
to operate inside Curated.

This is the operational document. The Canon defines what the company is and why. This document describes how it works, step by step, from the moment a member calls to the 90-day follow-up report that lands on the employer's desk.

If you're joining the team, this is your onboarding. If you're evaluating the model, this is the proof that it's been thought through. If you're the founder re-reading this at 2am, this is the checklist.

From first call to 90-day outcome report.

Every episode that flows through Curated follows the same lifecycle. The steps are sequential. The navigator owns the member relationship from intake through post-episode follow-up.

Step 1: Intake

The navigator is a licensed mental health professional (LCSW, LPC, LMFT, or equivalent). The intake is not a screening call. It's a clinical assessment: presenting symptoms, diagnostic history, current medications, prior treatment (what worked, what didn't), substance use history, family situation, geographic constraints, and member preferences.

The intake takes 30-45 minutes. The navigator documents it in the member record and uses it to drive the match. No algorithm makes the decision. The navigator does.

Step 2: Match

The navigator reviews the Curated network for programs that fit the member's clinical picture. Matching criteria:

• Clinical alignment. Does the program specialize in this diagnosis and acuity level?
• Outcome history. What are the program's completion and readmission rates for this type of case?
• Availability. Does the program have capacity for admission within an appropriate timeframe?
• Geography. Is the member willing and able to travel? Is proximity important for family involvement?
• Prior experience. Has the member been to this or a similar program before? What happened?
• Member preference. The member's input matters. A program the member resists is a program with a lower completion probability.

The navigator presents a recommendation to the member, explains why, and answers questions. If the member wants to consider alternatives, the navigator provides them. The member decides.

Step 3: Authorize

The bundled episode price is pre-negotiated. The navigator confirms the rate with the program, notifies the employer's benefits team, and coordinates admission logistics. The member pays nothing out of pocket. The employer's plan covers the bundled episode. If the employer's ASO carrier needs to process a claim for the episode, Curated provides the documentation.

Step 4: Monitor

During the episode, the navigator checks in with the program (not the member directly, unless the member wants it) to track progress. If the clinical picture changes, the navigator adjusts the plan. Discharge planning begins before discharge, not on the day of discharge.

Step 5: Transition

The navigator coordinates the step-down before the member leaves the program. This is where most systems fail. A member discharged from residential SUD without a therapist, a prescriber, and a peer support connection has a significantly higher relapse risk. The navigator's job is to make sure nobody walks out into a vacuum.

Step-down coordination includes:

• Outpatient therapist (matched to the member's clinical needs, not a random referral)
• Prescriber for ongoing medication management (if applicable)
• IOP enrollment (if stepping down from residential)
• Peer support specialist assignment (for every SUD episode, optional for others)
• Family communication (with member's consent)

Step 6: Measure

Validated clinical instruments are administered at three time points:

Additional metrics tracked per episode:

• Completion rate. Did the member complete the full prescribed treatment? Calculated by Curated independently.
• Readmission. Did the member require re-entry to acute or residential care within 6 months?
• MAT retention. For MAT episodes: is the member still engaged at 6 months?
• Instrument score change. PHQ-9/GAD-7/AUDIT-C delta from intake to discharge, and from discharge to 90 days.

How programs earn their way into the network.

Network inclusion is not an application process. Curated identifies programs, evaluates them against measurable criteria, and invites those that meet the standard. Programs that can't or won't provide outcome data are not considered.

Vetting criteria

Ongoing monitoring

Network inclusion is not permanent. Programs are monitored on a rolling basis:

• Quarterly outcome review. Completion rates, readmission rates, and instrument score changes are compared to network-wide benchmarks.
• Member feedback. Post-episode member surveys (separate from clinical instruments). Patterns of concern trigger review.
• Volume-triggered re-evaluation. After every 10 episodes at a specific program, a formal quality review is conducted.
• Removal process. Programs that fall below quality thresholds receive a written notice and a 90-day improvement window. If thresholds are not met, the program is removed from the network.

Contracting

Each program signs a provider agreement that includes:

• Bundled episode rate (pre-negotiated, all-inclusive)
• Payment terms (15 business days from episode completion)
• Outcome measurement requirements (access to clinical data at discharge, cooperation with 90-day follow-up)
• Quality standards and monitoring process
• Termination provisions (either party, 60-day notice)
• Hold-harmless clause (Curated provides navigation, not clinical treatment)

What we measure, when, and how the data flows.

The instruments

All instruments are validated, widely used, and free to administer. The operational cost is not the instrument. It's the follow-up infrastructure.

Data collection workflow

1. Intake: Navigator administers instruments during the intake assessment. Scores documented in member record.
2. Discharge: Program clinical staff administer the same instruments at discharge. Navigator verifies the data within 48 hours.
3. 90-day follow-up: Peer support specialist (SUD episodes) or navigator (all others) contacts the member via telehealth for instrument re-administration and readmission check.
4. Data entry: All scores entered into the Curated outcome database. Score deltas calculated automatically.
5. Reporting: Employer outcome report generated quarterly. Program-level and population-level views.

The 90-day follow-up

This is the hardest operational step and the most important. Getting members to respond 90 days after discharge requires:

• Peer support integration. For SUD episodes, the peer specialist is already in regular contact. The 90-day instrument is a natural part of the check-in, not a cold outreach.
• Navigator relationship. For non-SUD episodes, the navigator who did the intake reaches out. The member knows them. It's not a stranger calling.
• Multiple contact methods. Phone, text, telehealth video. The member chooses. Three attempts before marking as non-responsive.
• SMS nudge sequence. Brief text check-ins at days 7, 14, 30, 60, and 85 post-discharge. One question, one-word response. "How's it going? [Good / Rough / Call me]." The 90-day call becomes the capstone of an ongoing thread, not a cold outreach.
• Target completion rate: 55-65%. A 100% follow-up rate is aspirational but operationally unrealistic. The dataset is sampled, not exhaustive. That's acknowledged in all reporting.

What the employer receives

Quarterly outcome report containing:

• Total episodes routed through Curated (by clinical area)
• Completion rates (overall and by program)
• Readmission rates (6-month lookback)
• Clinical instrument score changes (average PHQ-9, GAD-7, AUDIT-C deltas)
• MAT retention rates (30/90/180-day)
• Cost summary (bundled rates vs. estimated carrier network rates, documented savings)
• 90-day follow-up completion rate
• Network quality actions (programs added, removed, or under review)

What a clinical navigator does
and what they don't.

Qualifications

• Licensed mental health professional (LCSW, LPC, LMFT, or equivalent state licensure)
• Minimum 3 years clinical experience in behavioral health or substance use treatment
• Direct experience with at least 2 of Curated's 13 clinical areas
• Telehealth competency (all navigation is remote)

What they do

• Conduct clinical intake assessments
• Match members to programs based on clinical judgment
• Coordinate admission logistics
• Monitor progress during the episode
• Plan and coordinate discharge transitions
• Arrange aftercare: outpatient therapy, prescribers, peer support, IOP
• Administer outcome instruments at intake and 90 days (for non-SUD episodes)
• Serve as the member's single point of contact throughout

What they don't do

• Provide clinical treatment. The navigator guides. The program treats. This distinction is legally essential.
• Override the member's choice. The navigator recommends. The member decides.
• Contact the member's employer. The employer receives aggregate outcome data. Never individual member information (HIPAA).
• Deny care. Curated does not perform utilization management. If a member needs care, the navigator finds the right program. Period.

Caseload

One navigator manages approximately 15-18 active episodes simultaneously across different stages of the lifecycle, plus up to 30 "dormant" members (completed an episode, still on the plan, navigator checks in quarterly). For a 10,000-life employer generating 40-60 episodes per year, two to three navigators provide coverage. The peer support specialist handles the 90-day follow-up caseload for SUD episodes, reducing navigator post-episode burden.

Longitudinal assignment

Navigator assignment is permanent for the duration of the member's plan tenure. Not episode-based. If a member completes residential SUD and has a new BH episode 14 months later, they call the same navigator. This continuity reduces intake time (the navigator already knows the history), improves matching accuracy (the navigator knows what worked and what didn't), and builds a longitudinal dataset that tracks member trajectories across multiple episodes and levels of care. The navigator maintains contact at 6 months and 12 months post-episode, in addition to the standard 90-day follow-up.

Crisis escalation protocol

When a member presents with active suicidal ideation, psychotic symptoms, or acute substance withdrawal during any contact with the navigator:

1. Immediate safety assessment. Navigator conducts a brief risk assessment using the Columbia Suicide Severity Rating Scale (C-SSRS) or equivalent.
2. Warm transfer. If imminent risk is identified, navigator stays on the line and connects the member to 988 (Suicide & Crisis Lifeline) or coordinates emergency services.
3. Documentation. All crisis contacts are documented in the member record within 1 hour.
4. Follow-up within 24 hours. Navigator or peer specialist makes a follow-up contact within 24 hours of any crisis event.
5. Clinical supervisor notification. All crisis events are reported to the clinical supervisor or Medical Director within the same business day.

How Curated fits into an employer's
existing benefits architecture.

Benefits design

Curated operates as a carve-out alongside the employer's existing carrier. The employer's ASO carrier continues to process claims and administer the plan. Curated is added as a supplemental benefit for high-acuity behavioral health episodes.

The employer's benefits team updates the plan document to include Curated as a covered benefit for specified clinical areas. Member communication materials are co-developed with Curated's team.

Member access

Members access Curated through:

• Direct phone line. A dedicated number staffed by navigators during business hours, with after-hours crisis triage.
• Employer benefits portal. A page within the employer's existing benefits site explaining Curated and how to access it.
• Referral from EAP. When the employer's EAP identifies a member who needs high-acuity care beyond the EAP's scope, they refer to Curated.
• HR/benefits team referral. The employer's HR team can direct members to Curated when they become aware of a need.

Data sharing

Carrier coordination

The employer's self-funded status gives them the legal right under ERISA to design their own plan benefits, including carve-outs. The ASO carrier may push back operationally. The employer's broker manages this conversation. Lantern, Carrum, and Progyny all operate under the same structure. It's standard in the benefits world.

Who you need at each stage.

90 days. One clinical area.
Prove it or walk away.

Pilot structure

1. Select one clinical area. Start with the employer's highest-cost BH category. Usually SUD residential or acute psychiatric. Don't try to cover all 13 areas in the pilot.
2. Define the population. Which members are eligible? All plan members, or a specific subset (e.g., dependents, a specific region)?
3. Set the PEPM. Pilot pricing is PEPM-only. No episode spread, no gain-share. The simplest possible yes.
4. Establish the baseline. What did the employer spend on this clinical area in the prior 12 months through the carrier network? How many episodes? What were the costs?
5. Run for 90 days. Route eligible episodes through Curated. Document everything. Measure outcomes.
6. Report. At day 90, present the employer with: episodes routed, programs used, costs vs. baseline, clinical outcomes (intake vs. discharge instruments), member satisfaction, and any quality actions taken.
7. Decision point. Expand to full deployment with PEPM + episode spread? Or walk away. The data decides.

What makes a pilot successful

• At least 5 episodes routed (enough to demonstrate the process, not enough for statistical significance)
• 100% completion of intake instruments
• Discharge instruments collected for all completed episodes
• Documented cost comparison vs. carrier network rates
• Member satisfaction at or above baseline
• No adverse events attributable to routing

What has to be in place before
the first member calls.

• Business entity. LLC or corporation registered in operating state.
• HIPAA compliance. BAA (Business Associate Agreement) with every employer and every provider. Curated handles PHI as a business associate of the employer's plan.
• Provider agreements. Executed with every network program. Includes bundled rates, payment terms, outcome measurement requirements, hold-harmless clause.
• Employer agreement. PEPM pricing, scope of services, data sharing terms, pilot/termination provisions.
• Errors and omissions insurance. Professional liability coverage for navigation services.
• General liability insurance. Standard business coverage.
• Member-facing language. Clear communication that the navigator provides guidance, not treatment. The clinical relationship is between the member and the program.
• Data security. Encrypted storage for member records, outcome data, and clinical instruments. SOC 2 not required at pilot stage but on the roadmap.
• State licensure review. Curated does not process claims or administer benefits (no TPA license needed). Navigation services may require review in specific states. Consult healthcare counsel.